Diffuse intrasinusoidal metastasis of gastric carcinoma to the liver leading to fulminant hepatic failure. A case report.
An unusual case of gastric carcinoma with diffuse intrasinusoidal metastasis to the liver (DIML) presenting as fulminant hepatic failure is reported. The patient was a 59-year-old man admitted to the hospital complaining of dysphagia. Seven weeks after performance of total gastrectomy, he developed jaundice and consciousness disturbance and died 4 days later. The surgical material was diagnosed as advanced cancer (poorly differentiated adenocarcinoma) of the stomach and postmortem examination disclosed massive and diffuse infiltration of the tumor cells into the hepatic sinusoids with no grossly detectable metastatic nodules. It is important to be aware that, although uncommon, gastric carcinomas may cause fulminant hepatic failure attributable to DIML. The clinicopathologic features of such cases are detailed and a review of the relevant literature included.
Sawabe
M
M
Division of Pathology, Cancer Institute Hospital, Tokyo, Japan.
Kato
Y
Y
Ohashi
I
I
Kitagawa
T
T
D002277:Carcinoma / Q000473:pathology*; D006501:Hepatic Encephalopathy / Q000209:etiology; D006801:Humans; D008107:Liver Diseases / Q000209:etiology*; D008113:Liver Neoplasms / Q000556:secondary*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology*